Jobs at Delta Dental of Michigan

Develop and implement statistical, machine learning, predictive, and optimization models to solve business challenges. Design data-driven experiments, prepare and validate structured and unstructured data, create visualizations, and communicate findings to technical and non-technical stakeholders. The role also leads adoption of new data science techniques and supports continuous improvement of organizational practices.

Evaluates business processes, transactions, records, systems, and technology to identify risk, ensure compliance, and improve operational controls. Performs sampling, data analysis, investigations, audit documentation, external audit support, remediation verification, and reporting. Maintains audit records and helps improve audit criteria, procedures, manuals, and dashboards. The role is fully remote but requires residence in Michigan within commuting distance of Okemos or Farmington Hills offices.

Application Development Interns will contribute to enterprise platforms using Angular, Java REST services, and scalable backend systems. Responsibilities include applying computer science principles, working with modern architectures and technologies, solving real-world problems, collaborating across teams, and communicating technical work to business audiences. Candidates should be enrolled in a relevant undergraduate or graduate program and have programming experience, web development knowledge, and understanding of data structures, algorithms, software architecture, object-oriented design, and design patterns.

Researches and resolves government-program dental appeals, grievances, compliance cases, billing issues, and fraud referrals. Reviews contracts, claims, treatment records, and provider documentation; communicates with customers, clients, affiliates, legal, and compliance teams; manages case deadlines and notices; prepares claims and adjustments; maintains case records; and supports audits and hearings.

Educates and assists participating dental providers with TennCare and CoverKids dental benefit programs, prior authorizations, electronic billing, compliance requirements, and documentation. Conducts annual office visits, monitors provider performance, resolves operational issues, and maintains healthcare provider relationships across Tennessee. The role requires regional travel and strong knowledge of dental terminology, procedure codes, billing, and benefit administration.

Analyzes and adjudicates dental claims for potential fraud and aberrant treatment patterns. The specialist prepares focused reviews, investigates questionable claims and reconsiderations, coordinates difficult adjustments, consults dental experts, documents determinations, and interprets dental policies, procedure codes, radiographs, images, and processing guidelines for internal and external contacts.

Analyzes provider billing, utilization, and treatment data to identify fraud, waste, abuse, outliers, and emerging trends. Develops predictive models, dashboards, reports, databases, scripts, and automated workflows supporting dental plan integrity initiatives. Conducts provider investigations, manages Focused Review recommendations and documentation, tracks performance and denial trends, resolves data issues, and provides insights for audits, regulatory requests, leadership decisions, and operational improvement.

Advances organizational development initiatives, coordinating workplans, stakeholder activities, training curricula, surveys, communications, and program documentation. Evaluates employee and stakeholder feedback, identifies themes, and recommends improvements involving engagement, employee experience, change management, and organizational effectiveness. The role independently manages multiple assignments, collaborates cross-functionally, and creates presentations, job aids, reports, and development resources.

Coordinates Enterprise Portfolio Management Office activities, including project intake, estimating, scheduling, milestone tracking, financial reporting, Agile delivery support, documentation, stakeholder communications, dashboards, and project closedown. Facilitates planning and working sessions, maintains portfolio data and SharePoint content, monitors risks and dependencies, supports PI Planning, and contributes to process improvement, compliance documentation, and accurate executive reporting.

Work on large-scale enterprise applications: build Angular front-ends, Java-based REST services, and scalable back-end systems. Learn SOA/EDA, REST/JSON, Kafka, containerization, RPA, and CMS. Apply CS fundamentals, data structures, algorithms, OO design, and communicate technical work to business stakeholders.

Support the Compliance department by conducting regulatory research, assisting with reporting and data analysis, developing and tracking compliance training, and reviewing policies and procedures to ensure adherence to state and federal requirements.

Support and manage the Compliance Program: develop and deliver training, monitor regulatory/document revisions, maintain document repository, coordinate audits (Medicare/Medicaid/ACA), perform risk assessment, track remediation, liaise with stakeholders, and ensure policies and procedures meet legal, contractual and regulatory requirements.

The role involves administering GRC and LMS platforms, performing data analysis, developing dashboards with Power-BI, and creating applications with PowerApps. The administrator serves as a liaison among departments, providing training and supporting technological initiatives.